Clindamycin

Question 1

MOA

Answer 1

Inhibits protein synthesis by reversibly binding to the 50S subunit

Bacteriostatic–>Time-dependent

Question 2

MOR

Answer 2

Alteration of the ribosomal binding site
- Ribosomal methylation by erm-encoded enzymes

Clindamycin is NOT a substrate for macrolide efflux pumps, and strains that are resistant to macrolides remain susceptible to clindamycin

Question 3

Spectrum of activity

Answer 3

Gram (+) aerobes
- MSSA, CA-MRSA

Gram (+) anaerobes–> most useful
- ADA
- Not C.diff

Gram (-) anaerobes

Question 4

Absorption

Answer 4

Rapidly and almost completely absorbed after oral administration; bioavailability approaches 90%

Question 5

Distribution

Answer 5

Penetrates into most body tissues and fluids including sputum, bile, pleural fluid and bone

DOES NOT PENETRATE CSF

Question 6

Metabolism/elimination

Answer 6

Primarily metabolized by the liver to metabolites excreted in the urine.

Enterohepatic circulation of clindamycin and its metabolites can lead to prolonged antimicrobial presence in the stool

NOT removed by hemodialysis

Question 7

Clinical uses

Answer 7

Infections due to anaerobes OUTSIDE THE CNS–> pulmonary, intraabdominal, diabetic foot infections

CA-MRSA

Alternative treatment of infections due to gram (+) aerobes in patients allergic to penicillin

Question 8

Adverse effects

Answer 8

N/V/D

C. diff (pseudomembranous colitis)

Hepatotoxicity